<? 
	global $FullUrl, $lg, $ArticleMainLast; 
	$_SESSION['captcha'] = mt_rand(10000, 99999);
?>
<div class="design-ask">
      <div class="tkyc"><a href="">
        <h2>Thiết kế websites theo yêu cầu</h2>
        </a></div>
      <div class="ask-content"> <span>We strive to know more about the needs of our customers to satisfy your needs with our products completely! With this wish box we would like to build a new communication channel. Let us know what you need and... </span>
        <form method="post" action="<?php echo $FullUrl; ?>/index.php?do=contact&act=send">
          <div class="row-left">
            <div class="row">
              <label style="width:110px;">Loại Template:</label>
              <select>
                <option>Nhà đất</option>
                <option>Bán hàng</option>
                <option>Tin tức</option>
                <option>Doanh nghiệp</option>
                <option>Blog</option>
              </select>
              <label style="width:50px">Hoặc:</label>
              <input type="text" class="clearable style1" size="10">
            </div>
            <div class="row">
              <textarea name="comment_contact" id="comment_contact" rows="10" cols="50">Ghi Chú</textarea>
            </div>
          </div>
          <div class="row-right">
            <div class="row">
              <p style="color:#999999; font-style:italic">Vài link website bạn muốn chúng tôi tham khảo</p>
              <div class="row">
                <label>Link 1:</label>
                <input type="text" name="link1_contact" id="link1_contact" class="clearable style1" size="30">
              </div>
              <div class="row">
                <label>Link 2:</label>
                <input type="text" name="link2_contact" id="link2_contact"class="clearable style1" size="30">
              </div>
              <div class="row"> Màu sắc <img src="<?=$FullUrl?>/<?=CST_IMAGES?>/bg_color.png" width="243" height="23" /></div>
              <div class="row">
                <label>
                Họ tên:
                <p class="batbuoc">*</p>
                </label>
                <input type="text" name="name_contact" id="name_contact" title="Vui lòng nhập vào họ tên" class="clearable style1" size="30">
              </div>
              <div class="row">
                <label>
                Điện thoại:
                <p class="batbuoc">*</p>
                </label>
                <input type="text" name="phone_contact" id="phone_contact" title="Vui lòng nhập vào số điện thoại" class="clearable style1" size="30">
              </div>
              <div class="row">
                <label>
                Email:
                <p class="batbuoc">*</p>
                </label>
                <input type="text" name="email_contact" id="email_contact" title="Vui lòng nhập vào địa chỉ email" class="clearable style1" size="30">
              </div>
              <div class="row">
                <input type="submit" value="Gửi yêu cầu" class="btn_submit">
              </div>
            </div>
          </div>          
Mã kiểm tra: <input type="text" name="number_captcha"><img src="<?=$FullUrl?>/lib/Captcha/PHP-CAPTCHA/php_captcha.php">
        </form>
      </div>
    </div>